Objective The purpose of this study is to confirm the putative association between the Fc?RⅢA-158F/V allele and rheumatoid arthritis (RA) by genotyping the Fc?RⅢA-158F/V polymorphism in patients and controls. Methods One hundred and ninety-two RA patients were recruited and all patients fulfilled the American College of Rheumatology 1987 revised criteria for RA. The demographic data including age, sex and disease duration were collected. The 192 RA patients and 179 control subjects were genotyped for Fc?RⅢA-158F/V polymorphism with a reliable polymorphism assay, nested PCR to investigate whether the Fc?RⅢA-158F/V polymorphism was a risk factor for RA. Results The frequency of Fc?RⅢA-158V/V homozygous was higher in RA patients (OR=3.1, P

Objective To investigate the significance of the Children's Rehabilitation Management System (ICR 2.0) for occupational therapy (OT) for cerebral palsy (CP). Methods 60 children with CP were divided into group A (n=30) and group B (n=30). The group A accepted OT program assisted with ICR 2.0, and the group B accepted OT program drawn by therapists experientially. They were assessed with Enjoji infant development scale and Fine Motor Function Measure (FMFM) before and 3 months after treatment. Results There was no significant difference in development months and the fine motor between 2 groups before treatment (P>0.05). Both the development and fine motor improved after treatment (P<0.001), and improved more in the group A than in the group B (P<0.05). Conclusion ICR 2.0 assisted OT program can further improve the recovery of children with CP.

Objective To evaluate the efficacy and safety of aripiprazole treatment for co-morbid attention defi?ciency hyperactivity disorder (ADHD) in children with Tourette syndrome (TS). Methods Forty four TS children with co-morbid ADHD were randomly divided into aripiprazole group and haloperidol group. The aripiprazole group and halo?peridol group received aripiprazole and haloperidol treatment for 12 weeks, respectively. Yale global tic severity scale (YGTSS) and Conners parent symptom questionnaire (PSQ) were used to assess the tic and ADHD symptoms before, 2, 4, 8 and 12 weeks after treatment. Side effects were recorded weekly. Results Repeated measure ANOVA indicated that the main effects of groups was not significant to the YGTSS scores (P>0.05), but significant to the PSQ scores (P<0.05). After 12-week treatment, the YGTSS scores between two groups were not significantly different (P>0.05). The PSQ scores of aripiprazole group were significantly lower than that of haloperidol group. The adverse reactions of aripiprazole group were milder compared with the haloperidol group (P<0.05). Conclusions The present study demonstrates that aripipra?zole has the same efficacy in the treatment of tics as haloperidol, improves co-morbid ADHD symptoms, and its adverse reactions are much less compared with haloperidol.

Objective To compare the efficacy of the conventional PPD skin test and a new enzymelinked immunospot assay(TSPOT-TB)for diagnosing latent tuberculosis infection(LTBI)in patients with rheumatic diseases.Methods Two hundred and sixty rheumatic patients were enrolled,and all were screened for LTBI based on clinical history,chest X-ray,PPD skin test or TSPOT.Results The positive rate of TSPOT assay was 24.1%and that of PPD skin test was 39.4%.The overall concordance rate between the 2tests was 61.0%.Among PPD negative patients (n=149).29 were TSPOT(+)(19.5%).Among PPD(+)patients(n=98),69 were TSPOT(-)(70.0%).The patients who got BCG vaccination or had history of tuberculosis infection showed a significantly higher rate of positive result of PPD skin test than those who did not (P<0.05 or P<0.01).While in TSPOT assay,the BCG vaccination or history of tuberculosis infection did not show influence on TSPOT results(P>0.05).Of the 127 patients who received biological agents after screening for LTBI,9 patients were pretreated with isoniazide.Twenty-seven patients stopped biological agent treatment because of the positive results of PPD or TSPOT.Twenty three patients who had positive PPD but negative TSPOT results received biological agent treatment without isoniazide,and none of them developed active tubereulosis after 6 to 18 months of follow-up.Conclusion BCG vaccination affects the result of PPD test in rheumatic patients,but has no influence on TSPOT results.The infection rate of latent tuberculosis of rheumatic patients in our research is 23.8%detected by TSPOT.

Objective To investigate a new single nucleotid polymorphism (SNP) intron5(+4668C/T) in SLC22A12 in primary gout patients and the association between clinical characteristics and genotypes. Methods One hundred and one primary gout patients and 186 healthy subjects were recruited into this study. Blood pressure, body mass index (BMI) was recorded. Serum uric acid, glucose, lipid and creatinine were detected. DNA was extracted from peripheral blood to amplify the fragment located in intron 5. The genotypes of SLC22A12 can be detected with high-resolution melting (HRM) assay, followed by sequencing analysis. Chi-square test was used for statistical analysis. Results ① A new SNP in intron 5 of SLC22A12 was identi-fied successfully by HRM, which was defined as intron 5 (+4668C/T). CC, CT and TT genotypes were unam-biguously distinguished with HRM technology, which was fully concordant with sequencing. ②The genotypes of CC, CT and TT in male and female groups were 28.1%, 33.7%, 38.2% and 20.0%, 47.1%, 32.9%, respectively.③ However, no significant differences of genotype distribution were found concerning BMI, blood pressure, creatinine, total cholesterol and triglyceride in both male group and female group. But the serum uric acid levels in the CC genotype were significantly higher than those with the CT+TT genotypes. ④ The genotype frequencies of CC and CT+TT in high uric acid group were remarkably different from those in low uric acid group (21.2%, 78.8%,; 35.0%, 65.0%; P<0.05). Conclusion A new SNP has been successfully discovered with HRM technology with simplicity, rapidity and accuracy. T allele of intron 5 (+4668C/T) may be a genetic protective factor for hyperuricemia among Chinese population.

Objective To evaluate a new enzyme-linked immunospot assay (TSPOT-TB) for the diagnosis of latent tuberculosis infection in patients with rheumatic diseases.Methods The rapid TSPOT-TB assay was applied to detect ESAT-6 and CFP-10 specific T cells in blood samples from 126 rheumatic disease patients.A PPD skin test was performed on all patients simultaneously.Results The positive rate of TSPOT assay was 23.8% and that of PPD skin test was 34.9%.The overall agreement between the 2 tests was 71.4%.Among PPD (-) patients (n=82),11 were TSPOT (+) ( 13.4% ).Among PPD (+) patients (n=44),25 were TSPOT(-) ( 56.8% ).The patients who got BCG vaccination showed a significantly higher rate of positive results of PPD skin test than those who did not(41% vs 19%,P＜0.05).While in TSPOT assay,the BCG vaccination did not show any influence on TSPOT results (22% vs 27%,P＞0.05).Conclusion BCG vaccina-tion affects the results of PPD test in patients with rheumatic diseases,but has no influence on TSPOT results.The infection rate of latent tuberculosis in patients with rheumatic diseases in our study is 23.8% detected by TSPOT.

Objective To investigate the relationship between HLA-B * 5801 allele and severe cutaneous adverse reactions caused by allopurinol or other drugs.The clinical value of HLA-B * 5801 as the marker of allopurinol-SCAR was evaluated.Methods Forty-three patients with allopurinol-SCAR,133 patients without SCAR after taking allopurinol for 3 months were included.Ninety-six patients with SCAR caused by other drugs and 148 healthy individuals were enrolled into the present study.HLA-B * 5801 allele was detected by PCR-SSP method.Data were analyzed by chi-square test.Results HLA-B * 5801 was present in 40 of 43 (93.0％) patients with allopurinol-SCAR,which was significantly higher than 19 of 148 (12.8％) in healthy subjects (x2=100.353,P＜0.01,OR=90.5,95％CI 25.5-321.8).But there were no significant differences between allopurinol-tolerant patients and healthy controls(10 of 133,7.5,x2=2.141,P＞0.05,OR=0.6,95％CI 0.2-1.2).And there were only 14 of 96 (7.5％) patients with SCAR caused by other drugs had HLA-B * 5801 (x2=0.152,P＞0.05,OR=1.2,95％CI 0.6-2.4).Conclusion The study indicates that people with HLA-B * 5801 have a high risk of allopurinol-SCAR.HLA-B * 5801 is a specific and predictive marker for guiding the selection of uric acid lowing drug allopurinol.

Objective To observe hepatitis B virus (HBV) reactivation in 12 patients with rheumatic disease undergoing immunosuppressive therapy and to evaluate whether preemptive antiviral therapy is necessary for patients receiving disease-modifying anti-rheumatic drugs (DMARDs).Methods From January 2008 to March 2012,a total of 12 HBV-infected patients with rheumatic diseases were consecutively enrolled into this long-term follow-up study.Liver function and serum levels of HBV DNA were tested during the follow-up.Results The medium duration of follow-up was 41 months (range 16-48).Four patients received steroid treatment,and among them two patients without pre-emptive antiviral therapy developed HBV reactivation.After administr-ation of LAM or ETV,HBV replication was controlled in both patients.Five patients were treated with disease-modifying anti-rheumatic drugs and the other three patients received tumor necrosis factor-alpha-blocking agents.None of these patients received pre-emptive antiviral therapy.HBV reactivation did not occur in any of them.Conclusion HBV reactivation does occur in HBV-infected patients with rheumatoid diseases after immunosuppressive therapy.Pre-emptive antiviral therapy should be administered in patients who are receiving steroid therapy for rheumatic diseases.In contrast,DMARDs and TNFBA are relatively safe for HBV-infected patients with rheumatic diseases.Close monitoring of HBV DNA and ALT levels is necessary to the mana-gement of HBV reactivation.

Objective To understand the pathogenesis of primary hypothyroidism associated with polymyositis-like syndrome.Method Four cases were presented and the clinical characteristics were analyzed.Results All of the four patients were male.Complaints of weakness primarily affecting proximal muscles and elevation of muscle enzymes were presented.Primary hypothyroidism was diagnosed after clinical examination.Complaints of weakness and the elevated muscle enzymes were all improved after the substitution of thyroxine.Conclusion Hypothyroidism could cause polymyositis-like syndrome,and thyroid function should be screened when elevation of muscle enzymes is presented.

Objective To explore the correlation between the level of serum uric acid and metabolic syndrome and associated factors including overweight,abnormality of blood glucose,blood lipid,and hypertension.Methods 654 cases of complete medical records,aging from 30-90with median age of 65 ,were completed were selected,Data base was established by using Excell software,meanwhile,single factor analysis and stepwise regression analysis were performed using SPSS 11.0 software package.Results The levels of serum uric acid of patients with overweight,high fasting blood glucose (FBG),hypertriglyceride (TG),high-density lipid cholesterol (HDL-C)and essential hypertension (EH)were higher than that of patients without overweight,normal fasting blood glucose,normal triglyceride,low high-density lipid cholesterol and without hypertension,respectively [respectively,(270.52 ±81.63 )μmol/L vs.(226.61 ± 67.42)μmol/L,t=-7.387,P=0.000;(265.71±73.50)μmol/Lvs.(235.03 ±75.00)μmol/L,t=-4.459,P=0.000;(262.80 ±74.45 )μmol/L vs.( 235.82±75.04)μmol/L,t=-3.927,P=0.000;(243.97 ±76.33)μmol/L vs.(212.78±57.60)μmol/L,t=-2.412,P=0.016;(282.87±64.79)μmol/L vs.( 180.22±41.60)μmol/L,t=22.59,P=0.000 ].The patients with metabolic syndrome (n=107)and the patients without metabolic syndrome (n=547)were included in our study.The level of serum uric acid of patients with metabolic syndrome was higher than that of patients without metabolic syndrome [(301.22±68.55 )μmol/L vs.(230.72±71.63)μmol/L,t=9.376,P=0.000].Stepwise regression analysis showed that there was positive correlation between systolic blood pressure (SBP),diastolic blood pressure (DBP),the body mass index (BMI),triglyceride (TG),high-density lipid cholesterol (HDL-C),fasting blood glucose (FBG)and the level of serum uric acid,respectively (t=3.409,13.401,6.979,2.943,3.514,4.706 respectively;P=0.000,0.001,0.000,0.003,0.000,0.000 respectively).Conclusion The level of serum uric acid in patients with metabolic syndrome is higher than those without metabolic syndrome.There is positive correlation between the level of serum uric acid and associated factors of metabolic syndrome including overweight,abnormality of blood glucose and blood lipid,and hypertension.